Contextual and individual determinants of oral health-related quality of life in older Brazilians.

ABSTRACT

PURPOSE: This cross-sectional, population-based study evaluated contextual and individual determinants on the oral health-related quality of life in older Brazilians. MATERIALS AND METHODS: Data from the National Survey of Oral Health were used. The sample was selected by multi-stage probability cluster sampling, with probability proportional to size. The Oral Impacts on Daily Performance (OIDP) was used to evaluate oral health-related quality of life (OHRQoL). Contextual variables of municipalities and individual variables of older people were included. Descriptive, bivariate and multilevel analyses were conducted. RESULTS: Of the sample of 7619 older Brazilians, 45.7% was impacted by at least one of the OIDP items. The item impact average was 1.2 (95% CI 1.04-1.37). The impact on OHRQoL was lower in older Brazilians residents in municipalities with the highest value of the GINI index (contextual variable) (p = 0.007), among edentulous people (p = 0.001) and dental prosthesis users (p < 0.001). This impact was greater among older people of nonwhite skin color (p = 0.024), lower family income (p = 0.024) and dissatisfied with the oral health (p < 0.001). CONCLUSION: A high prevalence of oral problems impacting OHRQoL in older Brazilians was identified. Furthermore, the impact prevalence was related to a positive situation in contextual determinants and a negative situation for the individual, showing a social inequalities profile in relation to individual determinants.